| Bethel Medical Center Llc | |
|
121 Congressional Ln 510 Rockville MD 20852-1542 | |
| (301) 675-5670 | |
| Not Available |
| Full Name | Bethel Medical Center Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 121 Congressional Ln, Rockville, Maryland |
| Authorized Official Name and Position | Emmanuel Brown (PRESIDENT) |
| Authorized Official Contact | 3016755670 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bethel Medical Center Llc Po Box 4593 Washington DC 20017-0593 Ph: () - | Bethel Medical Center Llc 121 Congressional Ln 510 Rockville MD 20852-1542 Ph: (301) 675-5670 |
| NPI Number | 1952773343 |
|---|---|
| Provider Enumeration Date | 10/24/2015 |
| Last Update Date | 03/23/2016 |
| Medicare PECOS PAC ID | 8123326923 |
|---|---|
| Medicare Enrollment ID | O20160412000803 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952773343 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | D0053941 (Maryland) | Primary |
| Provider Name | Emmanuel P Brown |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1841397601 PECOS PAC ID: 9739138579 Enrollment ID: I20050119000239 |
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